A Cohort Study: Comorbidity and Stage Affected the Prognosis of Melanoma Patients in Taiwan

Chin-Kuo Chang; Yih-Shou Hsieh; Pei-Ni Chen; Shu-Chen Chu; Jing-Yang Huang; Yu-Hsun Wang; James Cheng-Chung Wei

doi:10.3389/fonc.2022.846760

A Cohort Study: Comorbidity and Stage Affected the Prognosis of Melanoma Patients in Taiwan

Front Oncol. 2022 Mar 3:12:846760. doi: 10.3389/fonc.2022.846760. eCollection 2022.

Authors

Chin-Kuo Chang¹, Yih-Shou Hsieh^{1

2}, Pei-Ni Chen^{1

2}, Shu-Chen Chu³, Jing-Yang Huang⁴, Yu-Hsun Wang⁵, James Cheng-Chung Wei^{1

6

7}

Affiliations

¹ Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
² Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
³ Institute and Department of Food Science, Central Taiwan University of Science and Technology, Taichung, Taiwan.
⁴ Center for Health Data Science, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁵ Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁶ Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁷ Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.

Abstract

Background: Comorbidities and stages may influence the prognosis of melanoma patients in Taiwan and need to be determined.

Methods: We performed a retrospective cohort study by using the national health insurance research database in Taiwan. Patients with a primary diagnosis of melanoma by the Taiwan Cancer Registry from 2009 to 2017 were recruited as the study population. The comparison group was never diagnosed with melanoma from 2000 to 2018. The Charlson comorbidity index was conducted to calculate the subjects' disease severity. The Cox proportional hazards model analysis was used to estimate the hazard ratio of death.

Results: We selected 476 patients, 55.5% of whom had comorbidity. A higher prevalence of comorbidity was associated with a more advanced cancer stage. The mortality rate increased with an increasing level of comorbidity in both cohorts and was higher among melanoma patients. The interaction between melanoma and comorbidity resulted in an increased mortality rate.

Conclusion: An association between poorer survival and comorbidity was verified in this study. We found that the level of comorbidity was strongly associated with mortality. A higher risk of mortality was found in patients who had localized tumors, regional metastases, or distant metastases with more comorbidity scores. Advanced stage of melanoma patients with more comorbidities was significantly associated with the higher risk of mortality rate.

Keywords: comorbidity; melanoma; mortality rate; prognosis; stage; survival.